Bradbury A W, Ruckley C V
University Department of Surgery, Royal Infirmary, Edinburgh, Scotland.
J Vasc Surg. 1993 Nov;18(5):789-95.
The purpose of this study was to determine whether foot volumetry is of value in predicting the outcome after superficial venous surgery for chronic venous ulceration.
Fifty-three patients who underwent subfascial ligation of perforating veins with or without saphenous vein ligation for recurrent venous ulceration had foot volumetry performed before operation, immediately after operation (1 month), and at regular intervals during follow-up (median 60, range 3 to 144 months).
Fourteen patients (26%) had recurrent ulceration (median time to recurrence 48, range 10 to 72 months) and 39 patients remained ulcer free. Before operation expulsion fraction (EF) and half refilling time (HRT) were significantly higher in the no recurrence group. Both groups gained improvement in EF and HRT from their surgery; however, although this was sustained in the no recurrence group, by the time of first recurrence in the recurrence group, EF and HRT had returned to preoperative levels.
Preoperative foot volumetry can therefore predict failure after subfascial perforator and saphenous vein ligation, probably by identifying patients with deep venous incompetence. After operation deterioration in foot volumetry and can also be used to predict the onset of recurrent ulceration.
本研究旨在确定足部容积测量在预测慢性静脉溃疡浅表静脉手术后的结果方面是否具有价值。
53例因复发性静脉溃疡接受了带或不带大隐静脉结扎的筋膜下交通静脉结扎术的患者,在手术前、手术后即刻(1个月)以及随访期间(中位数60个月,范围3至144个月)定期进行足部容积测量。
14例患者(26%)出现复发性溃疡(复发的中位时间为48个月,范围10至72个月),39例患者溃疡未复发。术前,无复发组的排空分数(EF)和半充盈时间(HRT)显著更高。两组患者术后EF和HRT均有改善;然而,尽管无复发组的改善得以持续,但在复发组首次复发时,EF和HRT已恢复至术前水平。
因此,术前足部容积测量可能通过识别深静脉功能不全的患者来预测筋膜下交通静脉和大隐静脉结扎术后的失败情况。术后足部容积测量的恶化也可用于预测复发性溃疡的发生。